Shukla Lipi, Morrison Wayne A, Shayan Ramin
Regenerative Surgery Group, O'Brien Institute , Fitzroy, VIC , Australia ; Department of Plastic Surgery, St. Vincent's Hospital , Fitzroy, VIC , Australia ; Regenerative Surgery Group, Australian Catholic University and O'Brien Institute Tissue Engineering Centre (AORTEC) , Fitzroy, VIC , Australia.
Regenerative Surgery Group, O'Brien Institute , Fitzroy, VIC , Australia ; Department of Plastic Surgery, St. Vincent's Hospital , Fitzroy, VIC , Australia ; Regenerative Surgery Group, Australian Catholic University and O'Brien Institute Tissue Engineering Centre (AORTEC) , Fitzroy, VIC , Australia ; Department of Surgery, University of Melbourne , Melbourne, VIC , Australia.
Front Surg. 2015 Jan 28;2:1. doi: 10.3389/fsurg.2015.00001. eCollection 2015.
Radiotherapy is increasingly used to treat numerous human malignancies. In addition to the beneficial anti-cancer effects, there are a series of undesirable effects on normal host tissues surrounding the target tumor. While the early effects of radiotherapy (desquamation, erythema, and hair loss) typically resolve, the chronic effects persist as unpredictable and often troublesome sequelae of cancer treatment, long after oncological treatment has been completed. Plastic surgeons are often called upon to treat the problems subsequently arising in irradiated tissues, such as recurrent infection, impaired healing, fibrosis, contracture, and/or lymphedema. Recently, it was anecdotally noted - then validated in more robust animal and human studies - that fat grafting can ameliorate some of these chronic tissue effects. Despite the widespread usage of fat grafting, the mechanism of its action remains poorly understood. This review provides an overview of the current understanding of: (i) mechanisms of chronic radiation injury and its clinical manifestations; (ii) biological properties of fat grafts and their key constituent, adipose-derived stem cells (ADSCs); and (iii) the role of ADSCs in radiotherapy-induced soft-tissue injury.
放射疗法越来越多地用于治疗多种人类恶性肿瘤。除了有益的抗癌作用外，对靶肿瘤周围的正常宿主组织还存在一系列不良影响。虽然放射疗法的早期影响（脱皮、红斑和脱发）通常会消退，但慢性影响会作为癌症治疗不可预测且往往麻烦的后遗症持续存在，在肿瘤治疗完成后很长时间依然存在。整形外科医生经常被要求治疗受照射组织随后出现的问题，如反复感染、愈合受损、纤维化、挛缩和/或淋巴水肿。最近，有人偶然注意到——随后在更有力的动物和人体研究中得到证实——脂肪移植可以改善其中一些慢性组织影响。尽管脂肪移植应用广泛，但其作用机制仍知之甚少。本综述概述了目前对以下方面的理解：（i）慢性放射损伤的机制及其临床表现；（ii）脂肪移植及其关键成分脂肪来源干细胞（ADSCs）的生物学特性；（iii）ADSCs在放射治疗引起的软组织损伤中的作用。
